Age: 25 Pre op: 34 AA/ AAA Post op: Hoping for a FULL C cup Hight: 5'5 Weight: 124 lbs diameter : 28.5 Hello! I'm getting my BA in less than 3 weeks, confused on profile type and surface! I want a natural full looking breasts. I was thinking Mod. implants from what I've seen. But my PS that I am going with gave me the option to choose between Hp's and Mod-plus and textured silicon surface. so i'm a bit confused! wt do u recommend? is 300- 325 enough for a full C cup? smooth or textured?
Confused on Profile Type I Should Get, How do I Decide? (photo)
Doctor Answers (12)
High profile silicone implant should provide you with the best result
Thanks for the photos - they are very helpful. Given your body configuration, lack of breast tissue, etc. my recommendation would be for a high profile silicone implant placed behind the muscle. I would strongly recommend against a saline one for several reasons. The moderate profile implants will not provide you with as much projection as you may want given your narrow breast base and will significantly limit the volume of the implant that you could prudently use.
Finally, you may be better served with a smooth surfaced silicone implant as compared to a textured surfaced one though the difference between the two may be slight.
Choosing the right breast implant can be tricky
When we talk about breast implant surgery, there are 4 basic questions that need to be answered:
- What type of implant (saline vs silicone) (textured vs smooth)
- Incision choice (under the breast, around the areola, in the armpit, in the belly button)
- Placement above or below the pectoralis muscle
- Size of implant
The answers to the above questions depends on the expectations of the patient, the patient's anatomy, and the skill and expertise of the surgeon. Let's review the 4 questions with you in mind, but first let's define your anatomy.
You have very little breast tissue, the right breast is slightly larger than the left, the left inframammary crease sits higher on your chest wall than the right, the left nipple is just slightly higher than the right, you have a pectus excavatum deformity of your sternum (your breast bone is concave instead of convex), you have very prominent and protruding rib cage inferiorly, there is a large gap between your breasts (at least 3 cm). It is important to know that your bony anatomy can not be changed by implant surgery, your breast bone and rib cage will not change in shape or appearance. In fact, your breasts appear smaller than the actually are becasue of your anatomy and this needs to be calculated into your selection of implant style and size.
TYPE OF IMPLANT
You can choose either saline or silicone, smooth or textured. Because you are so thin and have very little breast tissue, wrinkling and rippling of the implant will be more noticiable. Saline implants and textured implants wrinkle more than silicone and smooth walled implants, so a smooth walled silicone implant would be the best choice for you.
High profile implants have less diameter and more projection than moderate profile implants. Because you have a wide gap between your breasts and the pectus deformity, a wider diameter implant is a better choice than a high profile to help close that gap and hide your bony abnormality.
Saline implants can be placed through any of the 4 incisions, silicone implants need a longer incision and with your anatomy the only choice would be the inframammary (under the breast) incision. Also, because of your prominent rib cage the belly button incision would be difficult and I would not recommend it.
ABOVE OR BELOW THE MUSCLE
Below the muscle gives a more natual look and feel. Since you are thin and have very little breast tissue, you definitely need to go under the muscle.
SIZE OF IMPLANT
The most difficult decision to make is the size of the implant. Look at as many before and after pictures of other women who are bulit like you and see what they chose. Try on implant sizers and talk to your PS about size. As implants increase in size, the diameter changes the most. You will need a fairly wide diameter implant to create cleavage, I would recommend between 350-400 cc's. I also would place a slightly larger implant on the left than the right to create better symmetry, say 400 cc on the left and 375 or 350 cc on the right.
My recommendation to you based on your statements and photographs would be a smooth, silicone, moderate profile style implant, under the muscle, through an inframammary incision size 350-400 cc's, with a larger implant on the left.
Good luck! I hope this helps.
Selecting a breast implant profile type
Based on your photographs, without breast dimensions, I think a moderate profile or HP saline or silicone implant would give you a nice result. I, however, never use textured implants for breast augmentation. As far as size, "trying on" implants in the office is a great way to choose implant sizes.
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The best way to determine what is right for you is based upon your desired volume, and your anatomy. In general, I prefer hp's or mod + in narrow women who want a decent amount of volume. I usually place them in a submuscular pocket especially in very thin women.
Choosing Implant Size and Profile
As you have been told, cup size is not an accurate way to picke implant size. However, based on your photos, you probably not be able to get to what most women would call a large C-cup because of the diameter of your breasts and the limited amount of loose skin. In most cases, smooth surface moderate plus profile implants give a very nice result. You should go to a Board certified plastic surgeon who can help you determine the largest implant you can have based on the parameters of breast diameter and available breast skin. Make sure you have a sizing session so you will have a good idea how you will look. And don't worry about cup size.
Cup size and implants profile
It is not really possible to predict cup size after breast augmentation. If you and your plastic surgeon have decided on an implant volume, you should see what implant profile fits within the width of your chest. On the other hand, if you are interested in a fair amount of projection, your plastic surgeon and you can discuss a moderate plus or high profile implant that will fit your chest width and go with that implant volume. You and your plastic surgeon can work with these 2 approaches to find a volume and projection that will best meet your goals.
Which implant profile to get?
I typically recommend moderate plus smooth silicone implants for the majority of my patients. I do offer all implant options but I feel this gives the most natural appearance and feel. I reserve high profile implants for very narrow chest patients that want large sized implants. Lastly, I use moderate implants for very wide chests. I hope this has been helpful.
What size implant
the most important thing for me is the diameter of the breast. that is the way to achieve a natural appearance. With the photos you sent, I think you will need closer to a 400 cc implant to give you a full c cup size. If your breasts are not wide enough to use a moderate profile plus implant which I prefer, then you need to use high profile implants, which I feel are not as natural. I do not use textured implants for augmentation procedures as I do not feel that they look as good. Go on line and look at photos of before and after photos to look for someone you like postop, and started with your volume now, to look for a size you like.
Choosing the right breast implant
If you have selected a surgeon (Board certified by the American Board of Plastic Surgery preferrably) that you are comfortable with, it is best to work out together what implant size and profile you would be most satisfied with. Based upon your photos, without the benefit of the physical examination), you appear to have a slender frame and chest and very little breast tissue. Based on this, I would tend to choose a higher profile implant, especially with silicone, with a smooth surface. Textured implants have a higher chance of rippling and rupture and very little proven benefits. The size of your implants can be approximated based on your physical exam and desired outcome in addition to the use of intraoperative sizers.
What Implant Profile
I agree with everything Dr. Pousti said about the procedure. I also find using pictures instead of words related to cup size helps me achieve a result closer to the patient's goals. I also find intraoperative sizers a valuable tool especially in thin women with a tight skin envelope which makes it difficult to determine how much the tissue will stretch to accommodate different implant sizes.
As tight as your skin envelope looks in the photos, you may not be able to get large implants to look natural if your tissue doesn't stretch much, regardless of the implant profile. High profile implants have more projection for the same diameter which is helpful in narrow chested women like you, but will make your breast look full in the upper pole and may look too rounded if you try to go too big. I tell my patients with your body type and size wish that I will make them as large as I can as long as they look natural. Going too large will just give you that fake look. This may or may not get you to a full C, but will look nice and compliment your frame.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.